Shift Transition

Night to Day:

• 0800 hrs – all new patients allocated to Pink or Blue teams

Day to Evening:

• 1400 hrs – all new patients allocated to Purple or Navy teams

• Pink and Blue teams will continue to manage their own patients and pick up new patients allocated to Purple or Navy teams (respectively) until handover

Evening to Night:

• 2200 hrs – all new patients allocated to the Teal team.
• Purple or Navy teams will continue to manage their own patients and pick up new patients allocated to Teal team until handover

EDSSU:

• patients continue to be cared for by the assigned doctor for the duration of that doctor’s shift

Working in Acute

19 Acute beds including

• 2 isolation rooms
• 2 Safe Assessment Rooms  (SAR 1 and SAR 2)  for mental health patients

Pt is triaged and allocated a bed space (or to “Acute WR” if no bed available)

Acute patients need a decision to admit or discharge within 2 hours

 ACN or bedside nurse may initiate assessment and treatments while awaiting medical assessment

After commencing your initial assessment, discuss all patients with the ED Senior allocated to your team within 30 minutes.

Complete the ED assessment within 2 hours and make referrals in consultation with the ED Senior

-> Patient referred for admission or discharged home

Working in Resus

3 Resus bays – 2 adult and 1 paediatric

The JMO’s role in Resus is to provide support to the senior medical staff in caring for patients with potentially life-threatening conditions 

• Resus and Cat 2 patients are “overheaded”
• If it is safe to do so, interrupt what you are doing to start seeing the patient
• All team members are responsible for attending to Resus & Cat 2 patients as soon as they are able.
• Negotiate who will have ongoing responsibility for the patient with the ED Senior  allocated to your team
• Follow your patient if they change to a different area of the ED.

JMOs will usually be part of a team providing initial assessment and management for Resus & Cat 2 patients. Typical tasks include:

• Initiate resuscitation e.g. DETECT or BLS/ALS protocols
• Obtain IV access
• Arrange appropriate blood tests and radiological investigations
• Complete the clerking of the patient
• Assist the registrar /FACEM as directed

Working in Fast Track

A variety of different assessment or treatment spaces:

• 4 non-monitored treatment beds “FT1- FT4”
• 5 consult rooms “Cons 1 – Cons 5” (including eye room)
• Procedure Room “Proc Rm” and Plaster Room “FT Plast Rm”
• Internal waiting room “FT WR”
• Reception when FT is full “FT reception”

The JMO’s role is to see and treat patients with 2 hours of arrival to ED. Patients should be seen in order of length of stay in ED unless directed otherwise by the ED senior.

CIN nurse may initiate treatments in reception/waiting room/CIN room. FT nurse will administer treatments to patient in FT WR, Cons and FT beds.

Take patients from reception/waiting room to a consult room for you to assess them. Patients may have a clipboard with their stickers and medical history questionnaire.

Please do not leave patients in the consult rooms

After initial assessment, patient may be sent:

• Home
• To Waiting Room (e.g. to await x-rays, further consultation)
• To an Acute bed or FT bed (e.g. for IVF)
• To EDSSU

If you identify a patient who is “sick” approach senior staff for review & move patient to Acute

• vital sign instability, potential for deterioration
• requiring intensive nursing intervention.

Follow your patient if they move to a different area of the ED.

Please discuss all your patients with the ED Senior allocated to your team within 30minutes.

Working in Paediatrics

7 paediatric beds:

• Paeds beds 1-5
• 2 isolation rooms “paeds 6 – 7”
• 1 procedure room “paeds proc”
• Paediatric waiting area : “paeds WR”

 The JMO’s role in paeds is to provide timely medical care to paediatric patients in the Emergency Department, AND to identify the sick child and seek immediate senior help

 JMOs are encouraged to care for all paediatric patients both medical and surgical.

• Interns should have the ED senior physically review all their patients
• All children under 12 months should be physically reviewed by the ED senior

Pt is triaged and allocated to a bed space or to paeds WR

ACN or paediatric nurse may initiate treatments while awaiting medical assessment

After making your initial assessment, discuss all paediatric patients with the ED Senior allocated to your team within 30 minutes.

Complete the ED assessment within 2 hours.

-> Patient referred for admission or discharged home

 Paediatric patients REQUIRING RESUSCITATION are cared for in Resus 4